Staging of oesophageal cancer

Staging systems are constantly being updated to help doctors plan the best treatment and help give an idea of the likely outcome. This means they are becoming increasingly detailed and complicated.

Stage 0 or carcinoma in situ (CIS) – This is a very early stage of oesophageal cancer. There are cancer cells present, but they are contained entirely within the lining of the oesophagus. Oesophageal cancer is not often diagnosed this early, as there are usually no symptoms at this stage.

Stage 1 – The cancer is found only in the surface layers of the lining of the oesophagus (mucosa/submucosa) or in a small part of the oesophagus. It has not spread to nearby tissues, lymph nodes or other organs.

Stage 2 – The cancer has either grown into the muscle layer of the oesophageal wall (muscularis) or spread to nearby lymph nodes, but has not spread to any other organs. If the cancer has not spread to nearby lymph nodes, it is stage 2A. If the cancer has spread to nearby lymph nodes, it is stage 2B.

Stage 3 – The cancer has grown through the wall of the oesophagus (adventitia). It may also have spread to nearby lymph nodes and other body tissues close to the oesophagus, but there is no spread to other parts of the body.

Stage 4 – The cancer has spread to lymph nodes and other parts of the body, such as the liver, lungs or stomach. This is known as secondary or metastatic cancer.

TNM staging

Your doctors may also describe your cancer using the TNM staging system. This staging system is more complex, and can give more precise information about the stage of your tumour. T refers to the size of the tumour. N refers to whether the cancer has spread to the lymph nodes. M refers to whether the cancer has spread to another part of the body such as the liver or lungs (secondary or metastatic cancer).

Tumour size (T)

T1 The cancer has grown into the inner layer (mucosa/sub-mucosa) of the oesophagus.

T2 The tumour has grown into the muscle layer (muscularis) of the oesophagus.

T3 The tumour has grown into the outer layer (adventitia) of the oesophagus.

T4 The tumour has spread to structures nearby the oesophagus such as the trachea (windpipe) or lung.

Lymph nodes (N)

N0 There are no cancer cells in any lymph nodes.

N1 There are cancer cells in nearby lymph nodes.

If cancer cells have spread to the lymph nodes, the nodes are said to be positive.

Metastases (M)

M0 The cancer cells have not spread elsewhere in the body.

M1 The cancer cells have spread to other parts of the body. This is called secondary or metastatic oesophageal cancer.